Healthcare Provider Details

I. General information

NPI: 1356473557
Provider Name (Legal Business Name): ANNE O AKINFENWA MA ,TLLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10909 HANNAN RD
ROMULUS MI
48174-1383
US

IV. Provider business mailing address

10909 HANNAN RD
ROMULUS MI
48174-1383
US

V. Phone/Fax

Practice location:
  • Phone: 734-893-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number6301012448
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6401008713
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: